Abstract
Background and objective:
Accurate detection of unconventional histologies (UH) in prostate cancer (PCa) is crucial for treatment planning and prognosis.This systematic review and meta-analysis aimed to evaluate the accuracy of multiparametric magnetic resonance imaging (mpMRI) in detecting UH on prostatectomy, particularly cribriform architecture (CA) and intraductal carcinoma (IDC-P), in patients with localized PCa.
Methods:
A literature search was conducted in major databases for studies published after 2000. Seventeen articles fulfilled the inclusion criteria and were eligible for qualitative analysis. Five studies met the inclusion criteria for meta-analysis.
Results:
The pooled sensitivity and specificity of mpMRI (Prostate Imaging Reporting and Data System (PI-RADS) cutoff 3) to detect cribriform architecture were 0.91 and 0.29. The proportion of cribriform lesions increased with higher PI-RADS scores (23.2% for PI-RADS 1-2 to 66.7% for PI-RADS 5). For intraductal carcinoma (IDC-P), two studies found that IDC-P lesions were visible on mpMRI and had lower apparent diffusion coefficient (ADC) values compared to acinar prostate cancer. Four studies evaluating combined CA/IDC-P found sensitivities ranging from 33 to 100%. Lower ADC values were associated with CA/IDC-P in some studies, but not in others. Overall, mpMRI demonstrated promising sensitivity but moderate specificity in detecting these aggressive histological variants, with continued challenges in accurate sampling and characterization of mpMRI.
Conclusions:
mpMRI shows high sensitivity but moderate specificity in detecting cribriform architecture in PCa, especially for high PI-RADS scores. These findings support the use of mpMRI for UH detection, but caution is advised in clinical interpretation. Larger prospective studies are needed to validate these results before routine clinical application.
Accurate detection of unconventional histologies (UH) in prostate cancer (PCa) is crucial for treatment planning and prognosis.This systematic review and meta-analysis aimed to evaluate the accuracy of multiparametric magnetic resonance imaging (mpMRI) in detecting UH on prostatectomy, particularly cribriform architecture (CA) and intraductal carcinoma (IDC-P), in patients with localized PCa.
Methods:
A literature search was conducted in major databases for studies published after 2000. Seventeen articles fulfilled the inclusion criteria and were eligible for qualitative analysis. Five studies met the inclusion criteria for meta-analysis.
Results:
The pooled sensitivity and specificity of mpMRI (Prostate Imaging Reporting and Data System (PI-RADS) cutoff 3) to detect cribriform architecture were 0.91 and 0.29. The proportion of cribriform lesions increased with higher PI-RADS scores (23.2% for PI-RADS 1-2 to 66.7% for PI-RADS 5). For intraductal carcinoma (IDC-P), two studies found that IDC-P lesions were visible on mpMRI and had lower apparent diffusion coefficient (ADC) values compared to acinar prostate cancer. Four studies evaluating combined CA/IDC-P found sensitivities ranging from 33 to 100%. Lower ADC values were associated with CA/IDC-P in some studies, but not in others. Overall, mpMRI demonstrated promising sensitivity but moderate specificity in detecting these aggressive histological variants, with continued challenges in accurate sampling and characterization of mpMRI.
Conclusions:
mpMRI shows high sensitivity but moderate specificity in detecting cribriform architecture in PCa, especially for high PI-RADS scores. These findings support the use of mpMRI for UH detection, but caution is advised in clinical interpretation. Larger prospective studies are needed to validate these results before routine clinical application.
| Original language | English |
|---|---|
| Number of pages | 13 |
| Journal | European Radiology |
| DOIs | |
| Publication status | Published - 30 Apr 2025 |
